What is Presbyopia?
Presbyopia is a progressive eye condition that happens to everyone later in life. People with presbyopia have a hard time focusing up close. While hyperopia is commonly known as farsightedness and myopia as nearsightedness, presbyopia might be called “oldsightedness.” The term presbyopia is derived from Greek and Latin origins that mean “old eyes.”
Although presbyopia is usually seen in adults over the age of 40, the exact age of onset varies from person to person and depends on what type of eyeglass prescription (if any) the individual wore prior to its development. Many people with myopia (near-sightedness) can read comfortably without eyeglasses or contact lenses even after age 40. Presbyopia may seem to appear suddenly, but the actual loss of flexibility in the lens takes place over a period of years.
Presbyopia is not a disease, and it cannot be prevented. There is no cure for presbyopia, but there many ways to improve near vision. Many new treatments are currently being researched (see below).
Presbyopia Signs and Symptoms
Early signs of presbyopia include a need to hold magazines, books, or other reading material at arm’s length in order to focus. Symptoms of presbyopia may include:
- Eye strain
- Blurred vision at normal reading distances
- Eye fatigue or general fatigued feeling, especially at the end of the day
- Squinting to focus on near objects
- Decrease in ability to focus on near objects
What Causes Presbyopia?
Presbyopia is caused by the aging process. When we are younger, the lens of the eye is flexible and changes its shape in order to focus up close – this process is called “accommodation.” As we age, the lens becomes progressively more rigid and loses its ability to accommodate. Trauma, occupation, and lifestyle may be factors for some people, but presbyopia is a natural part of the aging process and will eventually happen to everyone.
Presbyopia can be diagnosed by symptoms and age alone, although your eye doctor may perform a series of eye exams and tests. These may include:
- Visual acuity exam
- Refraction test
- Eye movement evaluation
- Pupil evaluation
- Slit lamp exam
- Dilated fundus exam
People with presbyopia may need treatment for both close-up vision and distance vision. Eyeglasses and contacts are common choices due to their affordability, availability, and convenience. A few surgical procedures are available, and several more are still undergoing trials. There are a number of different solutions to presbyopia, including:
- Reading glasses
- Monovision contact lenses (one eye set for near, one eye set for distance)
- Multifocal contact lenses (contact lenses with both distance and near vision built in)
- Laser vision correction with either monovision or blended vision.
- Multifocal intraocular lens implants
- Corneal inlays that increase depth of field
- Combinations of options above
Prognosis for Presbyopia
By definition, presbyopia is not a disease; it can always be corrected by glasses or contact lenses, and will never affect distance vision. Presbyopia worsens over time.
There are many treatment options that are newly available or currently undergoing trials. These include technologies to reshape or place inlays within the cornea, weaken the sclera, or to soften or replace the natural lens with an artificial “multifocal” lens. You should discuss these options with your eye care provider.
Talking to Your Eye Doctor
- What are my treatment options?
- Are you aware of any new treatment options that have recently come on the market?
- Is your clinic doing any research into the prevention or treatment of presbyopia?
- Which vitamins are good for my lens health?
- Am I a candidate for monovision or any other types of presbyopia treatments?
- Do I have any other eye problems that are contributing to vision loss?
- American Optometric Association, Presbyopia, http://www.aoa.org/x4697.xml
- J. DiGirolamo, MD “The Big Book of Family Eye Care” (Basic Health Publications, Inc., 2011) 57-70
- J. Anshel, MD “Smart Medicine for Your Eyes” (SquareOne Publishers, 2011) 296-298